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UK clinicians: revised PPE guidance must be backed by adequate supplies

<span>Photograph: James Veysey/Rex/Shutterstock</span>
Photograph: James Veysey/Rex/Shutterstock

Clinicians given the right to demand higher-specification personal protective equipment when dealing with coronavirus have warned that new guidance could count for little unless new supplies are made available.

New guidance, issued by the UK government, public health authorities and NHS England after criticism of previous guidelines, states that any clinician working in a hospital, primary care or community care setting within two metres of a suspected or confirmed coronavirus Covid-19 patient should wear an apron, gloves, surgical mask and eye protection “based on the risk”.

It was updated after fears that the existing rules were confusing and some healthcare professionals were not being adequately protected from the risk of contracting the virus and passing it on to others.

Employers and unions broadly welcomed the new guidance, issued on Thursday, which doubles the distance at which PPE is required, but warned that it must be backed by adequate supplies.

Dr Chaand Nagpaul, chair of council at the British Medical Association (BMA), said the doctors’ union had heard concerns from physicians in more than 30 hospital trusts about shortages. “What fundamentally matters is that doctors and healthcare workers get the adequate and appropriate supplies of PPE on the frontline,” he said. “Without these supplies, there is continued unacceptable danger to the health and lives of healthcare workers and their patients.”

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Doctors Association UK agreed that adequate supplies were key and said the requirement for long-sleeve protective gowns should have been extended in place of “flimsy plastic aprons”.

Reports have been rife of shortages and large variations in the level of PPE available. Pictures of healthcare workers who have created their own makeshift protective equipment out of bin bags and other materials have proved embarrassing for the government and NHS leaders. Staff have also improvised masks out of snorkels, bought kit from hardware stores, and used school science goggles to protect themselves.

Last week, the president of the Royal College of Surgeons, Professor Derek Alderson, urged members not to risk their health following widespread reports of shortages. He said the new guidance was an improvement, but so so long as shortages remain, “my warning still holds true”.

Niall Dickson, chief executive of the NHS Confederation, said the guidance was straightforward for “staff to apply it to the clinical reality they face, whether they work in hospitals or the community. It means that if they think they need protective kit in a particular situation, they should be able to access it and wear it. But guidance is not the whole answer. Staff will need the right training and the right equipment, including for example ‘fit test’ kits to make sure the masks are effective.

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“There have been real problems with distribution, we have been assured they are being addressed, and to be fair, in many places that is happening. But any remaining supply chain problems need to be dealt with without delay.”

Unite, which represents 100,000 NHS staff, said increasing supplies was “a national priority”.

The government said the new guidance “reflects the fact that coronavirus is now widespread in the community, meaning clinicians are more likely to see patients with the virus, some of whom may have minimal or no symptoms” and has the support of the World Health Organisation (WHO).

The previous guidance recommended PPE outside high-risk procedures when healthcare workers were within one metre of a patients with suspected or confirmed Covid-19. The new guidelines makes them consistent with the two-metre social distancing rule.

Professor Chris Whitty, chief medical officer for England, said: “NHS England and the government are working hard to secure the supply lines in this challenging period so staff have the appropriate equipment.”